Optic pathway involvement in the posterior reversible encephalopathy syndrome: A case report and review of the literature

Nana Fujii; Hiroyuki Fujii; Mitsuru Matsuki; Shugo Doi; Takenori Isozaki; Yuriko Watanabe; Akihiro Nakamata; Akifumi Fujita; Harushi Mori

doi:10.1016/j.radcr.2023.08.003

Optic pathway involvement in the posterior reversible encephalopathy syndrome: A case report and review of the literature

Radiol Case Rep. 2023 Aug 17;18(10):3769-3772. doi: 10.1016/j.radcr.2023.08.003. eCollection 2023 Oct.

Authors

Nana Fujii¹, Hiroyuki Fujii¹, Mitsuru Matsuki¹, Shugo Doi², Takenori Isozaki¹, Yuriko Watanabe¹, Akihiro Nakamata¹, Akifumi Fujita³, Harushi Mori¹

Affiliations

¹ Department of Radiology, Jichi Medical University, Tochigi, Japan.
² Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
³ Department of Radiology, Haga Red Cross Hospital, Tochigi, Japan.

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological condition characterized by reversible vasogenic edema of the white matter and acute neurological symptoms. PRES typically affects the parieto-occipital regions but rarely affects the optic pathway. Herein, we describe a case of central-variant PRES in a 57-year-old man with abnormal signal intensities in the optic pathway on magnetic resonance imaging (MRI). The patient underwent hemodialysis, initiated diuretics and antihypertensive medications, and the abnormal signal intensities of the brainstem and optic pathway on MRI improved. Although rare, PRES can affect the optic pathway, thus suggesting the possibility of fragility of the optic pathway itself to hyperperfusion.

Keywords: Magnetic resonance imaging; Optic pathway; Posterior reversible encephalopathy syndrome.

Publication types

Case Reports